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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65967_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65967_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65967_"><span class="title" itemprop="name">Testicular Cancer Screening (PDQ®)</span></h1><div class="subtitle whole_rhythm">Health Professional Version</div><p class="contrib-group"><span itemprop="author">PDQ Screening and Prevention Editorial Board</span>.</p><p class="small">Published online: March 10, 2017.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062754__111">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about testicular cancer screening. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.</p><p id="CDR0000062754__112">This summary is reviewed regularly and updated as necessary by the PDQ Screening and Prevention Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p></div><div id="CDR0000062754__1"><h2 id="_CDR0000062754__1_">Overview</h2><p id="CDR0000062754__2">Note: Separate PDQ summaries on <a href="/books/n/pdqcis/CDR0000062899/">Testicular Cancer Treatment</a> and <a href="/books/n/pdqcis/CDR0000304747/">Levels of Evidence for Cancer Screening and Prevention Studies</a> are also available.
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</p><div id="CDR0000062754__25"><h3>Benefits</h3><p id="CDR0000062754__26">Based on fair evidence, screening for testicular cancer would not result in an appreciable decrease in mortality, in part because therapy at each stage is so effective.</p><p id="CDR0000062754__83"><b>Magnitude of Effect: Fair evidence of no reduction in mortality.</b></p><ul id="CDR0000062754__84"><li class="half_rhythm"><div>Study Design: Opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.</div></li><li class="half_rhythm"><div>Internal Validity: Not applicable (N/A).</div></li><li class="half_rhythm"><div>Consistency: N/A.</div></li><li class="half_rhythm"><div>External Validity: N/A. </div></li></ul></div><div id="CDR0000062754__27"><h3>Harms</h3><p id="CDR0000062754__28">Based on fair evidence, screening for testicular cancer would result in unnecessary diagnostic procedures with attendant morbidity.</p><p id="CDR0000062754__85"><b>Magnitude of Effect: Fair evidence for rare but serious harms.</b></p><ul id="CDR0000062754__52"><li class="half_rhythm"><div>Study Design: Opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.</div></li><li class="half_rhythm"><div>Internal Validity: N/A.</div></li><li class="half_rhythm"><div>Consistency: N/A.</div></li><li class="half_rhythm"><div>External Validity: N/A.</div></li></ul></div></div><div id="CDR0000062754__6"><h2 id="_CDR0000062754__6_">Description of the Evidence</h2><div id="CDR0000062754__7"><h3>Background</h3><div id="CDR0000062754__86"><h4>Incidence and mortality</h4><p id="CDR0000062754__87">It is estimated that 8,850 new cases of testicular cancer will be diagnosed in men, and 410 men will die of this disease in the United States in 2017.[<a class="bk_pop" href="#CDR0000062754_rl_6_1">1</a>] Testicular cancer is the most common malignancy in men aged 15 to 34 years.[<a class="bk_pop" href="#CDR0000062754_rl_6_2">2</a>,<a class="bk_pop" href="#CDR0000062754_rl_6_3">3</a>] It accounts for approximately 1% of all cancers in men. Worldwide, testicular cancer has more than doubled in the last 40 years. Incidence varies considerably in different geographical areas, being highest in Scandinavia and Switzerland; intermediate in the United States, Australia, and the United Kingdom; and lowest in Asia and Africa. It also varies according to ethnic groups, with a much higher rate among whites than blacks in the American population.[<a class="bk_pop" href="#CDR0000062754_rl_6_4">4</a>] An annual increase of 3% is reported for Caucasian populations.[<a class="bk_pop" href="#CDR0000062754_rl_6_5">5</a>] Despite the increase in observed incidence, there has been a dramatic decrease in mortality as a result of effective treatments. </p><p id="CDR0000062754__88">Unlike most other cancers, testicular cancer is generally found in young men. In
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white men, testicular cancer is the most common cancer from age 20 years to age 34 years and the
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second most common from age 35 years to age 39 years.[<a class="bk_pop" href="#CDR0000062754_rl_6_6">6</a>]</p><p id="CDR0000062754__89">Approximately 68% of testicular cancers are localized, 18% are regional, and 12%
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are distant stage at diagnosis.[<a class="bk_pop" href="#CDR0000062754_rl_6_6">6</a>] Although there has been no appreciable change in the stage distribution at
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diagnosis, advances in treatment have been associated with a 60% decrease in
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mortality. The majority of testicular cancers are curable even at advanced stages, and it would be impractical to document a further decrease
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in mortality associated with screening.</p><p id="CDR0000062754__104">Germ cell tumors (GCTs) of the testis constitute 94% of testicular tumors and include five basic cell types:[<a class="bk_pop" href="#CDR0000062754_rl_6_7">7</a>]</p><ul id="CDR0000062754__105"><li class="half_rhythm"><div> Seminoma.</div></li><li class="half_rhythm"><div>Embryonal carcinoma.</div></li><li class="half_rhythm"><div>Yolk sac tumor.</div></li><li class="half_rhythm"><div>Teratoma.</div></li><li class="half_rhythm"><div>Choriocarcinoma.</div></li></ul><p id="CDR0000062754__90">Sixty percent of GCTs are seminomas; the remainder are nonseminomatous GCTs. Almost half of all GCTs contain more than one of the five cell types.[<a class="bk_pop" href="#CDR0000062754_rl_6_7">7</a>]</p><p id="CDR0000062754__91">Three subtypes of pure seminomas have been described: classic, anaplastic, and spermatocytic. Classic seminoma accounts for 80% to 85% of all seminomas and occurs most commonly in men aged 30 to 50 years. Anaplastic seminoma accounts for 5% to 10% of all seminomas and has an age distribution similar to that of the typical subtype. A number of features suggest that anaplastic seminoma is a more aggressive and potentially more lethal variant of typical seminoma. These characteristics include greater mitotic activity, higher rate of local invasion, increased rate of metastatic spread, and higher rate of tumor marker (human chorionic gonadotropin [hCG] beta, or beta hCG) production. Spermatocytic seminoma accounts for 2% to 12% of all seminomas, and nearly half occur in men older than 50 years. The cells closely resemble different phases of maturing spermatogonia. The metastatic potential of this tumor is extremely low, and the prognosis is favorable.[<a class="bk_pop" href="#CDR0000062754_rl_6_8">8</a>]</p></div></div><div id="CDR0000062754__9"><h3>Risk Factors</h3><p id="CDR0000062754__10"> Testicular cancer is more than four times more common among
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white men than black men,[<a class="bk_pop" href="#CDR0000062754_rl_6_8">8</a>,<a class="bk_pop" href="#CDR0000062754_rl_6_9">9</a>] with intermediate incidence rates for Hispanics,
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American Indians, and Asians. High-risk groups exist. Males with
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cryptorchidism have 3 to 17 times the average risk. Approximately 7% to 10% of patients with testicular tumors have a history of cryptorchidism.[<a class="bk_pop" href="#CDR0000062754_rl_6_7">7</a>,<a class="bk_pop" href="#CDR0000062754_rl_6_8">8</a>] Although the association is established, the biological mechanism underlying the association remains uncertain; testicular cancer and cryptorchidism may share environmental and/or genetic risk factors; or, it is the ectopic position <i>per se</i> that is a postnatal risk factor for testicular cancer, or it is a combination of the two.[<a class="bk_pop" href="#CDR0000062754_rl_6_7">7</a>] Orchiopexy may not prevent cancer in these children but allows clinical surveillance of patients with a previously impalpable gonad. </p><p id="CDR0000062754__92">There is also an increased
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risk in males with gonadal dysgenesis and Klinefelter syndrome.[<a class="bk_pop" href="#CDR0000062754_rl_6_10">10</a>] Men with
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a family history of testicular cancer may be at a higher risk of this
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disease.[<a class="bk_pop" href="#CDR0000062754_rl_6_11">11</a>] A history of testicular cancer is associated with a higher risk of
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a contralateral tumor.[<a class="bk_pop" href="#CDR0000062754_rl_6_7">7</a>
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,<a class="bk_pop" href="#CDR0000062754_rl_6_8">8</a>] Although not consistently found, infertility, testicular atrophy, twinship, or
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abnormal semen parameters have been associated with a higher risk of testicular
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cancer, but the evidence is weak.[<a class="bk_pop" href="#CDR0000062754_rl_6_7">7</a>,<a class="bk_pop" href="#CDR0000062754_rl_6_12">12</a>-<a class="bk_pop" href="#CDR0000062754_rl_6_14">14</a>]</p><p id="CDR0000062754__93">There is a low cumulative risk of metachronous contralateral testicular
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cancer and a favorable overall survival of patients diagnosed with
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metachronous contralateral testicular cancer.[<a class="bk_pop" href="#CDR0000062754_rl_6_15">15</a>] Future research is necessary to delineate the genetic and environmental risk factors for testicular cancer.[<a class="bk_pop" href="#CDR0000062754_rl_6_16">16</a>]</p><div id="CDR0000062754__94"><h4>Carcinoma <i>in situ</i></h4><p id="CDR0000062754__95">An additional risk factor for the development of testicular cancer is the presence of carcinoma <i>in situ</i> (CIS), also called intratubular germ cell neoplasia. Testicular CIS appears to develop from fetal gonocytes and is characterized histologically by seminiferous tubules containing only Sertoli cells and malignant-appearing germ cells.[<a class="bk_pop" href="#CDR0000062754_rl_6_17">17</a>]</p><p id="CDR0000062754__96">Early reports suggest that CIS is associated with the development of contralateral
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testicular cancer in 50% of patients at 5 years of follow-up.[<a class="bk_pop" href="#CDR0000062754_rl_6_18">18</a>] CIS will be found in approximately 5% of contralateral testes (approximately
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the same rate as cryptorchid testes).[<a class="bk_pop" href="#CDR0000062754_rl_6_19">19</a>]</p><p id="CDR0000062754__97">There is controversy regarding the clinical significance and management of CIS of the testis.[<a class="bk_pop" href="#CDR0000062754_rl_6_8">8</a>] Treatment options for CIS include observation, radiation therapy, chemotherapy, and orchiectomy. Although low-dose radiation therapy can preserve Leydig cell function and prevent GCT development, a conservative approach of observation may also be warranted. Individuals at high risk (e.g., cryptorchidism, atrophic testis, and intersex conditions) require close observation.</p></div></div><div id="CDR0000062754__98"><h3>Evidence of Benefit Associated With Screening</h3><p id="CDR0000062754__99">The sensitivity, specificity, and positive predictive value of routine screening of asymptomatic men for testicular cancer are not known.[<a class="bk_pop" href="#CDR0000062754_rl_6_20">20</a>,<a class="bk_pop" href="#CDR0000062754_rl_6_21">21</a>] In a report of a single-center case series of men being evaluated for infertility, testicular symptoms, or erectile dysfunction, 1,320 men underwent testicular ultrasound.[<a class="bk_pop" href="#CDR0000062754_rl_6_22">22</a>] Focal lesions were found in 27 (2%) men, 17 of the lesions were palpable and 10 were nonpalpable. Eighty percent of the lesions were ultimately shown to have benign histologies, for a positive predictive value of about 0.2. It is not clear if early discovery of the cancers resulted in clinical benefit, and the positive predictive value is likely to be lower in the target population of asymptomatic men in the screening setting.</p><p id="CDR0000062754__100">Most testicular cancers are first detected by the patient, either unintentionally or by self-examination. Some are discovered by routine physical examination. However, no studies have been done to determine the effectiveness of testicular self-examination or clinical testicular examination in reducing mortality from testicular cancer. An updated systematic review performed on behalf of the U.S. Preventive Services Task Force, published in 2010, found no randomized trials, cohort studies, or case-control studies that examined benefits of testicular cancer screening (whether by physical examination, self-examination, or other screening tests) in an asymptomatic population.[<a class="bk_pop" href="#CDR0000062754_rl_6_21">21</a>] Likewise, a systematic Cochrane Collaboration review found no randomized or quasi-randomized controlled trials that evaluated the effectiveness of screening by a health professional or patient self-examination.[<a class="bk_pop" href="#CDR0000062754_rl_6_23">23</a>]</p><p id="CDR0000062754__101">Screening would be very unlikely to decrease mortality substantially because therapy is so effective at virtually all stages of disease.[<a class="bk_pop" href="#CDR0000062754_rl_6_24">24</a>](Refer to the PDQ summary on <a href="/books/n/pdqcis/CDR0000062899/">Testicular Cancer Treatment</a> for more information.) However, early detection may affect therapy. There is an increase in both the number of courses of chemotherapy and the extent of surgery required for treatment of advanced disease that results in higher morbidity. Patients diagnosed with localized disease require less treatment and have lower morbidity.[<a class="bk_pop" href="#CDR0000062754_rl_6_25">25</a>]</p></div><div id="CDR0000062754__102"><h3>Evidence of Harm Associated With Screening</h3><p id="CDR0000062754__103">Harms of screening for testicular cancer are poorly quantified. They may include false positive tests [<a class="bk_pop" href="#CDR0000062754_rl_6_22">22</a>] and resulting anxiety as well as subsequent unwarranted invasive diagnostic procedures. Two systematic reviews found no studies that provided a quantitative assessment of the harms of screening. [<a class="bk_pop" href="#CDR0000062754_rl_6_21">21</a>,<a class="bk_pop" href="#CDR0000062754_rl_6_23">23</a>]</p></div><div id="CDR0000062754_rl_6"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062754_rl_6_1">American Cancer Society: Cancer Facts and Figures 2017. Atlanta, Ga: American Cancer Society, 2017. <a href="https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2017/cancer-facts-and-figures-2017.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">Available online</a>. Last accessed October 13, 2017.</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_2">McGlynn KA, Devesa SS, Sigurdson AJ, et al.: Trends in the incidence of testicular germ cell tumors in the United States. Cancer 97 (1): 63-70, 2003. [<a href="https://pubmed.ncbi.nlm.nih.gov/12491506" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12491506</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_3">Garner MJ, Turner MC, Ghadirian P, et al.: Epidemiology of testicular cancer: an overview. Int J Cancer 116 (3): 331-9, 2005. [<a href="https://pubmed.ncbi.nlm.nih.gov/15818625" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15818625</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_4">Huyghe E, Matsuda T, Thonneau P: Increasing incidence of testicular cancer worldwide: a review. J Urol 170 (1): 5-11, 2003. [<a href="https://pubmed.ncbi.nlm.nih.gov/12796635" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12796635</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_5">Horwich A, Shipley J, Huddart R: Testicular germ-cell cancer. Lancet 367 (9512): 754-65, 2006. [<a href="https://pubmed.ncbi.nlm.nih.gov/16517276" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16517276</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_6">Howlader N, Noone AM, Krapcho M, et al., eds.: SEER Cancer Statistics Review, 1975-2012. Bethesda, Md: National Cancer Institute, 2015. <a href="http://seer.cancer.gov/csr/1975_2012/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">Also available online</a>. Last accessed November 30, 2017.</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_7">Dieckmann KP, Pichlmeier U: Clinical epidemiology of testicular germ cell tumors. World J Urol 22 (1): 2-14, 2004. [<a href="https://pubmed.ncbi.nlm.nih.gov/15034740" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15034740</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_8">Richie JP, Steele GS: Neoplasms of the testis. In: Campbell MF, Wein AJ, Kavoussi LR: Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier, 2007, pp 893-935.</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_9">Moul JW, Schanne FJ, Thompson IM, et al.: Testicular cancer in blacks. A multicenter experience. Cancer 73 (2): 388-93, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/8293405" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8293405</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_10">Henderson BE, Benton B, Jing J, et al.: Risk factors for cancer of the testis in young men. Int J Cancer 23 (5): 598-602, 1979. [<a href="https://pubmed.ncbi.nlm.nih.gov/37169" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37169</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_11">Dieckmann KP, Pichlmeier U: The prevalence of familial testicular cancer: an analysis of two patient populations and a review of the literature. Cancer 80 (10): 1954-60, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9366298" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9366298</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_12">Jacobsen R, Bostofte E, Engholm G, et al.: Risk of testicular cancer in men with abnormal semen characteristics: cohort study. BMJ 321 (7264): 789-92, 2000. [<a href="/pmc/articles/PMC27489/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC27489</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11009515" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11009515</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_13">Walsh TJ, Croughan MS, Schembri M, et al.: Increased risk of testicular germ cell cancer among infertile men. Arch Intern Med 169 (4): 351-6, 2009. [<a href="/pmc/articles/PMC2881689/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2881689</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19237718" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19237718</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_14">Hotaling JM, Walsh TJ: Male infertility: a risk factor for testicular cancer. Nat Rev Urol 6 (10): 550-6, 2009. [<a href="https://pubmed.ncbi.nlm.nih.gov/19724246" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19724246</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_15">Fosså SD, Chen J, Schonfeld SJ, et al.: Risk of contralateral testicular cancer: a population-based study of 29,515 U.S. men. J Natl Cancer Inst 97 (14): 1056-66, 2005. [<a href="https://pubmed.ncbi.nlm.nih.gov/16030303" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16030303</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_16">Richiardi L, Pettersson A, Akre O: Genetic and environmental risk factors for testicular cancer. Int J Androl 30 (4): 230-40; discussion 240-1, 2007. [<a href="https://pubmed.ncbi.nlm.nih.gov/17488341" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17488341</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_17">Olesen IA, Hoei-Hansen CE, Skakkebaek NE, et al.: Testicular carcinoma in situ in subfertile Danish men. Int J Androl 30 (4): 406-11; discussion 412, 2007. [<a href="https://pubmed.ncbi.nlm.nih.gov/17705813" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17705813</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_18">Jørgensen N, Müller J, Giwercman A, et al.: Clinical and biological significance of carcinoma in situ of the testis. Cancer Surv 9 (2): 287-302, 1990. [<a href="https://pubmed.ncbi.nlm.nih.gov/1964624" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1964624</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_19">Dieckmann KP, Loy V: Prevalence of contralateral testicular intraepithelial neoplasia in patients with testicular germ cell neoplasms. J Clin Oncol 14 (12): 3126-32, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8955658" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8955658</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_20">U.S. Preventive Services Task Force: Screening for testicular cancer: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med 154 (7): 483-6, 2011. [<a href="https://pubmed.ncbi.nlm.nih.gov/21464350" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21464350</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_21">Lin K, Sharangpani R: Screening for testicular cancer: an evidence review for the U.S. Preventive Services Task Force. Ann Intern Med 153 (6): 396-9, 2010. [<a href="https://pubmed.ncbi.nlm.nih.gov/20855803" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20855803</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_22">Carmignani L, Gadda F, Gazzano G, et al.: High incidence of benign testicular neoplasms diagnosed by ultrasound. J Urol 170 (5): 1783-6, 2003. [<a href="https://pubmed.ncbi.nlm.nih.gov/14532776" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14532776</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_23">Ilic D, Misso ML: Screening for testicular cancer. Cochrane Database Syst Rev (2): CD007853, 2011. [<a href="https://pubmed.ncbi.nlm.nih.gov/21328302" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21328302</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_24">Feldman DR, Bosl GJ, Sheinfeld J, et al.: Medical treatment of advanced testicular cancer. JAMA 299 (6): 672-84, 2008. [<a href="https://pubmed.ncbi.nlm.nih.gov/18270356" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18270356</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062754_rl_6_25">Sagalowsky AI: Expectant management of stage A nonseminomatous testicular tumors. In: Ratiff TL, Catalona WJ, eds.: Genitourinary Cancer. Boston: Martinus Nijhoff, 1987, pp 225-237.</div></li></ol></div></div><div id="CDR0000062754__21"><h2 id="_CDR0000062754__21_">Changes to This Summary (03/10/2017)</h2><p id="CDR0000062754__24">The PDQ cancer information summaries are reviewed regularly and updated as
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new information becomes available. This section describes the latest
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changes made to this summary as of the date above.</p><p id="CDR0000062754__108"><b><a href="#CDR0000062754__6">Description of the Evidence</a></b></p><p id="CDR0000062754__109">Updated <a href="#CDR0000062754__87">statistics</a> with estimated new cases and deaths for 2017 (cited American Cancer Society as reference 1).</p><p id="CDR0000062754__disclaimerHP_3">This summary is written and maintained by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/screening-prevention" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Screening and Prevention Editorial Board</a>, which is
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editorially independent of NCI. The summary reflects an independent review of
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the literature and does not represent a policy statement of NCI or NIH. More
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information about summary policies and the role of the PDQ Editorial Boards in
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maintaining the PDQ summaries can be found on the <a href="#CDR0000062754__AboutThis_1">About This PDQ Summary</a> and <a href="http://www.cancer.gov/publications/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ® - NCI's Comprehensive Cancer Database</a> pages.
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</p></div><div id="CDR0000062754__AboutThis_1"><h2 id="_CDR0000062754__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062754__AboutThis_2"><h3>Purpose of This Summary</h3><p id="CDR0000062754__AboutThis_3">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about testicular cancer screening. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.</p></div><div id="CDR0000062754__AboutThis_4"><h3>Reviewers and Updates</h3><p id="CDR0000062754__AboutThis_5">This summary is reviewed regularly and updated as necessary by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/screening-prevention" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Screening and Prevention Editorial Board</a>, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p><p id="CDR0000062754__AboutThis_22"> Board members review recently published articles each month to determine whether an article should:</p><ul id="CDR0000062754__AboutThis_6"><li class="half_rhythm"><div>be discussed at a meeting,</div></li><li class="half_rhythm"><div>be cited with text, or</div></li><li class="half_rhythm"><div>replace or update an existing article that is already cited.</div></li></ul><p id="CDR0000062754__AboutThis_7">Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.</p><p id="CDR0000062754__AboutThis_9">Any comments or questions about the summary content should be submitted to Cancer.gov through the NCI website's <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.</p></div><div id="CDR0000062754__AboutThis_10"><h3>Levels of Evidence</h3><p id="CDR0000062754__AboutThis_11">Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Screening and Prevention Editorial Board uses a <a href="/books/n/pdqcis/CDR0000304747/">formal evidence ranking system</a> in developing its level-of-evidence designations.</p></div><div id="CDR0000062754__AboutThis_12"><h3>Permission to Use This Summary</h3><p id="CDR0000062754__AboutThis_13">PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks succinctly: [include excerpt from the summary].”</p><p id="CDR0000062754__AboutThis_14">The preferred citation for this PDQ summary is:</p><p id="CDR0000062754__AboutThis_15">PDQ® Screening and Prevention Editorial Board. PDQ Testicular Cancer Screening. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/testicular/hp/testicular-screening-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/testicular/hp/testicular-screening-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389404]</p><p id="CDR0000062754__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>, a collection of over 2,000 scientific images.
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</p></div><div id="CDR0000062754__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062754__AboutThis_19">The information in these summaries should not be used as a basis for insurance reimbursement determinations. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062754__AboutThis_20"><h3>Contact Us</h3><p id="CDR0000062754__AboutThis_21">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>.</p></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65967.3/?report=reader">PubReader</a></li><li><a href="/books/NBK65967.3/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65967" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65967" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Screening and Prevention Editorial Board. Testicular Cancer Screening (PDQ®): Health Professional Version. 2017 Mar 10. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65967.13/">NBK65967.13</a></span> December 31, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65967.12/">NBK65967.12</a></span> March 6, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65967.11/">NBK65967.11</a></span> April 28, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK65967.10/">NBK65967.10</a></span> February 25, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65967.9/">NBK65967.9</a></span> August 11, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65967.8/">NBK65967.8</a></span> March 18, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65967.7/">NBK65967.7</a></span> August 12, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK65967.6/">NBK65967.6</a></span> February 20, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK65967.5/">NBK65967.5</a></span> March 6, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65967.4/">NBK65967.4</a></span> March 7, 2018</li><li><span class="bk_col_itm">NBK65967.3</span> March 10, 2017 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65967.2/">NBK65967.2</a></span> March 4, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65967.1/">NBK65967.1</a></span> February 13, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062754__1" ref="log$=inpage&link_id=inpage">Overview</a></li><li><a href="#CDR0000062754__6" ref="log$=inpage&link_id=inpage">Description of the Evidence</a></li><li><a href="#CDR0000062754__21" ref="log$=inpage&link_id=inpage">Changes to This Summary (03/10/2017)</a></li><li><a href="#CDR0000062754__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65783/">Patient Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related information</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="discovery_db_links" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pmc&DbFrom=books&Cmd=Link&LinkName=books_pmc_refs&IdsFromResult=2825272" ref="log$=recordlinks">PMC</a><div class="brieflinkpop offscreen_noflow">PubMed Central citations</div></li><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pubmed&DbFrom=books&Cmd=Link&LinkName=books_pubmed_refs&IdsFromResult=2825272" ref="log$=recordlinks">PubMed</a><div class="brieflinkpop offscreen_noflow">Links to PubMed</div></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389220" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Testicular Cancer Treatment (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Testicular Cancer Treatment (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/31846265" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Testicular Cancer Treatment (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Testicular Cancer Treatment (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/28876831" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Thyroid Cancer Screening (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Thyroid Cancer Screening (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Screening and Prevention Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389383" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Prostate Cancer Screening (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Prostate Cancer Screening (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Screening and Prevention Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389300" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Skin Cancer Screening (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Skin Cancer Screening (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Screening and Prevention Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=26389404" 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